Issue |
J Extra Corpor Technol
Volume 23, Number 3, September 1991
|
|
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Page(s) | 90 - 93 | |
DOI | https://doi.org/10.1051/ject/199123390 | |
Published online | 21 August 2023 |
Original Article
A Prospective Analysis of Creatinine Clearance During ECMO and Ultrafiltration
Harvard Medical School, The Children's Hospital, Boston MA
Ultrafiltration (UF) during neonatal ECMO was shown not to impair renal function in our retrospective review of 17 patients from 1986-1988. Creatinine production (UV) was assumed to be 10 mg/kg/ day for creatinine clearance (CrCl) calculations. To validate this assumption and to better understand renal function during ECMO, CrCl was measured prospectively on 27 non-surgical neonates. Seven patients required hemofiltration for fluid management. TypicalUFrateswere3-10ml/kg/hour. Two patients were excluded from analysis secondary to pre-existing renal disease. Renal CrCl was defined as UV /P where U=urine creatinine (mg/dl/24h), V =urine volume (ml/24h) and P=plasma creatinine (mg/ dl). In 20 control patients who did not receive UF, UV or creatinine excretion was 11.6+0.4mg/kg/24h (mean+SEM). No significant change over time was seen in mean CrCl of the control group. The UF group, however, demonstrated a steady decrease in mean CrCl. CrCl on the fourth day before the start of UF was significantly higher (P=0.05) than day three of UF. In conclusion: 1) the assumption of UV used in the retrospective study was supported; 2) CrCl decreases during UF; 3) the consistency of CrCl in the control population suggests no alteration in glomerular filtration during ECMO runs of 3-8 days.
Key words: Creatinine Clearance / Ultrafiltration / ECMO / Hemofiltration / Extracorporeal
© 1991 AMSECT
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